Influence of partial volume correction in staging of head and neck squamous cell carcinoma using PET/CT

• Published in: The quarterly journal of nuclear medicine and molecular imaging Vol. 58; no. 3; pp. 319 - 328
• Main Authors: Fayad, H, Le Pogam, A, Lamare, F, Fernandez, P, Pradier, O, Valette, G, Visvikis, D, Cheze Le Rest, C
• Format: Journal Article
• Language: English
• Published: Italy Edizioni Minerva Medica 01-09-2014
• Subjects: Aged; Algorithms; Cancer; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; Cells; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - secondary; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medical diagnosis; Middle Aged; Multimodal Imaging - methods; Neoplasm Staging - methods; Nuclear medicine; Positron-Emission Tomography - methods; Radiopharmaceuticals; Reproducibility of Results; Sensitivity and Specificity; Squamous Cell Carcinoma of Head and Neck; Tomography, X-Ray Computed - methods; Tumor Burden
• ISSN: 1824-4785; 1827-1936

PET/CT is widely used for the detection of lymph node involvement in head and neck squamous cell carcinoma (HNSCC). However, PET qualitative and quantitative capabilities are hindered by partial volume effects (PVE). Therefore, a retrospective study on 32 patients (57 lymph nodes) was carried out to evaluate the potential improvement of PVE correction (PVEC) in FDG PET/CT imaging for the diagnosis of HNSCC. Histopathological analysis of lymph nodes following neck dissection was used as the gold standard.
A previously proposed deconvolution based PVEC approach was used to derive improved quantitative accuracy PET images, while the anatomical lymph node volumes were determined on the CT images. Different parameters including SUVmax and SUVmean were derived from both original and PVEC PET images for each patient.
Histopathology confirmed that SUVmax and SUVmean after PVEC allows a statistically significant differentiation of malignant and benign lymph nodes (P<0.05). The sensitivity of SUVmax and SUVmean was 64% and 57% respectively with or without PVEC. PVEC increased specificity from 71% to 76% for SUVmax and 57% to 66% for SUVmean. Corresponding accuracy increased from 66% to 71% for SUVmax and from 59% to 66% for SUVmean. However, the most accurate differentiation between benign and malignant nodes was obtained while using the magnitude of SUVmax increase after PVEC with a corresponding sensitivity, specificity and accuracy of 77%, 82% and 80% respectively.
Our work shows that the use of partial volume effects correction allows a more accurate nodal staging using FDG PET imaging in HNSCC.